Abstract
The European Union has set ambitious CO
2
reduction targets, stimulating renewable energy production and accelerating deployment of offshore wind energy in northern European waters, mainly ...the North Sea. With increasing size and clustering, offshore wind farms (OWFs) wake effects, which alter wind conditions and decrease the power generation efficiency of wind farms downwind become more important. We use a high-resolution regional climate model with implemented wind farm parameterizations to explore offshore wind energy production limits in the North Sea. We simulate near future wind farm scenarios considering existing and planned OWFs in the North Sea and assess power generation losses and wind variations due to wind farm wake. The annual mean wind speed deficit within a wind farm can reach 2–2.5 ms
−1
depending on the wind farm geometry. The mean deficit, which decreases with distance, can extend 35–40 km downwind during prevailing southwesterly winds. Wind speed deficits are highest during spring (mainly March–April) and lowest during November–December. The large-size of wind farms and their proximity affect not only the performance of its downwind turbines but also that of neighboring downwind farms, reducing the capacity factor by 20% or more, which increases energy production costs and economic losses. We conclude that wind energy can be a limited resource in the North Sea. The limits and potentials for optimization need to be considered in climate mitigation strategies and cross-national optimization of offshore energy production plans are inevitable.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
An extensive new multi-proxy database of paleo-temperature time series (Temperature 12k) enables a more robust analysis of global mean surface temperature (GMST) and associated uncertainties than was ...previously available. We applied five different statistical methods to reconstruct the GMST of the past 12,000 years (Holocene). Each method used different approaches to averaging the globally distributed time series and to characterizing various sources of uncertainty, including proxy temperature, chronology and methodological choices. The results were aggregated to generate a multi-method ensemble of plausible GMST and latitudinal-zone temperature reconstructions with a realistic range of uncertainties. The warmest 200-year-long interval took place around 6500 years ago when GMST was 0.7 °C (0.3, 1.8) warmer than the 19
Century (median, 5
, 95
percentiles). Following the Holocene global thermal maximum, GMST cooled at an average rate -0.08 °C per 1000 years (-0.24, -0.05). The multi-method ensembles and the code used to generate them highlight the utility of the Temperature 12k database, and they are now available for future use by studies aimed at understanding Holocene evolution of the Earth system.
Clock synchronization is an enabling service for a wide range of applications and protocols in both wired and wireless networks. We study the implications of clock drift and communication latency on ...the accuracy of clock synchronization when scaling the network diameter. Starting with a theoretical analysis of synchronization protocols, we prove tight bounds on the synchronization error in a model that assumes independently and randomly distributed communication delays and slowly changing drifts. While this model is more optimistic than traditional worst-case analysis, it much better captures the nature of real-world systems such as wireless networks. The bound on the synchronization accuracy, which is roughly the square root of the network diameter, is achieved by the novel PulseSync protocol. Extensive experiments demonstrate that PulseSync is able to meet the predictions from theory and tightly synchronizes large networks. This contrasts against an exponential growth of the skew incurred by the state-of-the-art protocol for wireless sensor networks. Moreover, PulseSync adapts much faster to network dynamics and changing clock drifts than this protocol.
Fossil pollen records are well-established indicators of past vegetation changes. The prevalence of pollen across environmental settings including lakes, wetlands, and marine sediments, has made ...palynology one of the most ubiquitous and valuable tools for studying past environmental and climatic change globally for decades. A complementary research focus has been the development of statistical techniques to derive quantitative estimates of climatic conditions from pollen assemblages. This paper reviews the most commonly used statistical techniques and their rationale and seeks to provide a resource to facilitate their inclusion in more palaeoclimatic research. To this end, we first address the fundamental aspects of fossil pollen data that should be considered when undertaking pollen-based climate reconstructions. We then introduce the range of techniques currently available, the history of their development, and the situations in which they can be best employed. We review the literature on how to define robust calibration datasets, produce high-quality reconstructions, and evaluate climate reconstructions, and suggest methods and products that could be developed to facilitate accessibility and global usability. To continue to foster the development and inclusion of pollen climate reconstruction methods, we promote the development of reporting standards. When established, such standards should 1) enable broader application of climate reconstruction techniques, especially in regions where such methods are currently underused, and 2) enable the evaluation and reproduction of individual reconstructions, structuring them for the evolving open-science era, and optimising the use of fossil pollen data as a vital means for the study of past environmental and climatic variability. We also strongly encourage developers and users of palaeoclimate reconstruction methodologies to make associated programming code publicly available, which will further help disseminate these techniques to interested communities.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
BACKGROUND—Reduced electrogram amplitude has been shown to correlate with diseased myocardium. We describe a novel individualized approach for catheter ablation of atrial fibrillation (AF) based on ...low-voltage areas (LVAs) in the left atrium (LA). We sought to assess (1) the incidence of LVAs in patients undergoing AF catheter ablation, (2) the distribution of LVAs within the LA, and (3) the effect of an individualized ablation strategy on long-term rhythm outcomes.
METHODS AND RESULTS—In 178 patients with paroxysmal or persistent AF, LA voltage maps were created during sinus rhythm after circumferential pulmonary vein isolation. Subsequent substrate modification was confined to the presence of LVA (<0.5 mV) and inducible regular atrial tachycardias. LVAs were identified in 35% and 10% of patients with persistent and paroxysmal AF, respectively. The LA roof and the anterior, septal, and posterior wall LA were most often affected. The 12-month atrial tachycardias/AF-free survival was 62% for patients without LVAs and 70% for patients with LVAs and tailored substrate modification (P=0.3). Success rate in a comparison group of 26 LVA patients without further substrate modification was 27%.
CONCLUSIONS—LVAs can be found at preferred sites in 10% of patients with paroxysmal AF and in 35% of patients with persistent AF. This is the first clinical report describing a consistent voltage-based approach for substrate modification in addition to circumferential pulmonary vein isolation irrespective of AF type. Application of this limited individualized approach may have the potential to compensate for the impaired 12-month outcome of patients with endocardial structural defects.
Pulsed field ablation (PFA) is a novel atrial fibrillation (AF) ablation modality that has demonstrated preferential tissue ablation, including no oesophageal damage, in first-in-human clinical ...trials. In the MANIFEST-PF survey, we investigated the 'real world' performance of the only approved PFA catheter, including acute effectiveness and safety-in particular, rare oesophageal effects and other unforeseen PFA-related complications.
This retrospective survey included all 24 clinical centres using the pentaspline PFA catheter after regulatory approval. Institution-level data were obtained on patient characteristics, procedure parameters, acute efficacy, and adverse events. With an average of 73 patients treated per centre (range 7-291), full cohort included 1758 patients: mean age 61.6 years (range 19-92), female 34%, first-time ablation 94%, paroxysmal/persistent AF 58/35%. Most procedures employed deep sedation without intubation (82.1%), and 15.1% were discharged same day. Pulmonary vein isolation (PVI) was successful in 99.9% (range 98.9-100%). Procedure time was 65 min (38-215). There were no oesophageal complications or phrenic nerve injuries persisting past hospital discharge. Major complications (1.6%) were pericardial tamponade (0.97%) and stroke (0.4%); one stroke resulted in death (0.06%). Minor complications (3.9%) were primarily vascular (3.3%), but also included transient phrenic nerve paresis (0.46%), and TIA (0.11%). Rare complications included coronary artery spasm, haemoptysis, and dry cough persistent for 6 weeks (0.06% each).
In a large cohort of unselected patients, PFA was efficacious for PVI, and expressed a safety profile consistent with preferential tissue ablation. However, the frequency of 'generic' catheter complications (tamponade, stroke) underscores the need for improvement.
Left atrial (LA) low-voltage areas (LVAs) are frequently observed in patients with atrial fibrillation (AF) and may predict AF recurrence after catheter ablation.
The aim of this study was to develop ...and validate a clinical tool to identify LVAs that are associated with AF recurrence after pulmonary vein isolation (PVI).
In a cohort of 238 patients, voltage maps were created during LA procedures. LVAs were defined as areas with electrogram amplitudes <0.5 mV. On the basis of regression analysis, predictors of LA substrate were identified. These parameters were used to establish a dedicated risk score (DR-FLASH score, based on diabetes mellitus, renal dysfunction, persistent form of AF, LA diameter >45 mm, age >65 years, female sex, and hypertension). This risk score was then prospectively validated in a multicenter cohort of 180 patients. The association of the score with long-term recurrence of atrial arrhythmias after circumferential PVI was tested in a retrospective cohort of 484 patients.
The DR-FLASH score effectively identified LVA substrate (C statistic = 0.801, P < .001). In the prospective multicenter validation cohort, the predictive value of the DR-FLASH score was confirmed (C statistic = 0.767, P < .001). The probability for the presence of LA substrate increased by a factor of 2.2 (95% confidence interval CI 1.6-2.9, P < .001) with each point scored. Furthermore, the risk of AF recurrence after PVI increased by a factor of 1.3 (95% CI 1.1-1.5, P < .001) with every additional point and was almost 2 times higher in patients with a DR-FLASH score >3 (odds ratio 1.7, 95% CI 1.1-2.8, P = .026).
The DR-FLASH score may be useful to identify patients who may require extensive substrate modification instead of PVI alone.
Background: Several algorithms have been proposed for differentiating the right and left outflow tracts (RVOT/LVOT) arrhythmia origins from 12-lead electrocardiograms (ECGs); however, the procedure ...is complicated. A deep learning (DL) model, a form of artificial intelligence, can directly use ECGs and depict the importance of the leads and waveforms. This study aimed to create a visualized DL model that could classify arrhythmia origins more accurately.Methods and Results: This study enrolled 80 patients who underwent catheter ablation. A convolutional neural network-based model that could classify arrhythmia origins with 12-lead ECGs and visualize the leads that contributed to the diagnosis using a gradient-weighted class activation mapping method was developed. The average prediction results of the origins by the DL model were 89.4% (88.2–90.6) for accuracy and 95.2% (94.3–96.2) for recall, which were significantly better than when a conventional algorithm is used. The ratio of the contribution to the prediction differed between RVOT and LVOT origins. Although leads V1 to V3 and the limb leads had a focused balance in the LVOT group, the contribution ratio of leads aVR, aVL, and aVF was higher in the RVOT group.Conclusions: This study diagnosed the arrhythmia origins more accurately than the conventional algorithm, and clarified which part of the 12-lead waveforms contributed to the diagnosis. The visualized DL model was convincing and may play a role in understanding the pathogenesis of arrhythmias.
Arrhythmia recurrences after catheter ablation occur in up to 50% within one year but their prediction remains challenging. Recently, we developed a novel score for the prediction of rhythm outcomes ...after single AF ablation demonstrating superiority to other scores. The current study was performed to 1) prove the predictive value of the APPLE score in patients undergoing repeat AF ablation and 2) compare it with the CHADS2 and CHA2DS2-VASc scores.
Rhythm outcome between 3-12 months after AF ablation were documented. The APPLE score (one point for Age >65 years, Persistent AF, imPaired eGFR (<60 ml/min/1.73m2), LA diameter ≥43 mm, EF <50%) was calculated in every patient before procedure.
379 consecutive patients from The Leipzig Heart Center AF Ablation Registry (60±10 years, 65% male, 70% paroxysmal AF) undergoing repeat AF catheter ablation were included. Arrhythmia recurrences were observed in 133 patients (35%). While the CHADS2 (AUC 0.577, p = 0.037) and CHA2DS2-VASc scores (AUC 0.590, p = 0.015) demonstrated low predictive value, the APPLE score showed better prediction of arrhythmia recurrences (AUC 0.617, p = 0.002) than other scores (both p<0.001). Compared to patients with an APPLE score of 0, the risk (OR) for arrhythmia recurrences was 2.9, 3.0 and 6.0 (all p<0.01) for APPLE scores 1, 2, or ≥3, respectively.
The novel APPLE score is superior to the CHADS2 and CHA2DS2-VASc scores for prediction of rhythm outcomes after repeat AF catheter ablation. It may be helpful to identify patients with low, intermediate or high risk for recurrences after repeat procedure.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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